Development of a Novel Anisotropic Self-Inflating Tissue Expander: In Vivo Submucoperiosteal Performance in the Porcine Hard Palate

Marc C. Swan, David G. Bucknall, Jan T. Czernuszka, David W. Pigott, Timothy E. E. Goodacre

Research output: Contribution to journalArticle

Abstract

Background: The advent of self-inflating hydrogel tissue expanders heralded a significant advance in the reconstructive potential of this technique. Their use, however, is limited by their uncontrolled isotropic (i.e., uniform in all directions) expansion.

Methods: Anisotropy (i.e., directional dependence) was achieved by annealing a hydrogel copolymer of poly(methyl methacrylate-co-vinyl pyrrolidone) under a compressive load for a specified time period. The expansion ratio is dictated by the percentage of vinyl pyrrolidone content and the degree of compression. The expansion rate is modified by incorporating the polymer within a silicone membrane. The in vivo efficacy of differing prototype devices was investigated in juvenile pigs under United Kingdom Home Office Licence. The devices were implanted within a submucoperiosteal pocket in a total of six porcine palates; all were euthanized by 6 weeks after implantation. A longitudinal volumetric assessment of the expanded tissue was conducted, in addition to postmortem analysis of the bony and mucoperiosteal palatal elements.

Results: Uncoated devices caused excessive soft-tissue expansion that resulted in mucoperiosteal ulceration, thus necessitating animal euthanasia. The silicone-coated devices produced controlled soft-tissue expansion over the 6-week study period. There was a statistically significant increase in the volume of expanded soft tissue with no evidence of a significant acute inflammatory response to the implant, although peri-implant capsule formation was observed. Attenuation of the bony palatal shelf was noted.

Conclusion: A unique anisotropic hydrogel device capable of controlled expansion has been developed that addresses a number of the shortcomings of the technology hitherto available. (Plast. Reconstr. Surg. 129: 79, 2012.)

Original languageEnglish
Pages (from-to)79-88
Number of pages10
JournalPlastic and Reconstructive Surgery
Volume129
Issue number1
DOIs
Publication statusPublished - Jan 2012

Keywords

  • BREAST RECONSTRUCTION
  • OSMOTIC EXPANDERS
  • SOFT-TISSUE
  • PIG SKIN
  • EXPANSION
  • HYDROGELS
  • REPAIR
  • FISTULA
  • DEFECT
  • ERA

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